NEW QRUR’s (Quality Resource Use Reports) available as of Nov. 16th and new 12/11 informal review deadline

Thursday, November 19, 2015

CMS has identified issues that impacted the 2014 Annual Quality and Resource Use Reports (QRURs) released on September 8, 2015. There were issues with data submitted via electronic health record (EHR) and Qualified Clinical Data Registry (QCDR), as well as a technical issue with the claims used to calculate claims-based measures. CMS has successfully corrected these issues and produced revised 2014 Annual QRURs, which are now available via the CMS Enterprise Portal.

For a small percentage of groups, this correction resulted in a change to their Value-Based Payment Modifier (Value Modifier) calculation, and these groups will receive a separate notification. We strongly encourage  groups of 10+ EP’s access and review your TIN’s Newer 2014 QRUR as soon as possible.

The 2014 Annual QRURs show how groups and solo practitioners performed in 2014 on the quality and cost measures used to calculate the 2016 Value Modifier. For groups with 10+ EPs that are subject to the 2016 Value Modifier, the QRUR shows how the Value Modifier will apply to physician payments under the Medicare Physician Fee Schedule (MPFS) for physicians who bill under the group in 2016. For all other groups and solo practitioners, the QRUR is for informational purposes only and will not affect their payments under the MPFS in 2016.

How to access your TIN’s revised 2014 Annual QRUR

Authorized representatives for a group or solo practitioner can access the 2014 Annual QRURs on the CMS Enterprise Portal using an Enterprise Identify Data Management (EIDM)- formally known as IACS, account with the correct role. For more information on how to access the 2014 Annual QRURs, visit How to Obtain a QRUR.

For groups with 10+ EP’s, subject to the 2016 Value Modifier, CMS established an Informal Review Period to request a correction of a perceived error in their 2016 Value Modifier calculation and for PQRS group practices and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustment.. The informal review period for the 2016 Value Modifier and PQRS payment adjustment is now have until 11:59pm Eastern Time on December 11, 2015, to submit an informal review requesting CMS to investigate incentive eligibility and/or payment adjustment determination. Please contact Purdue Healthcare Advisors if questions or additional guidance is needed.


Writer: Patty Rose, 574-229-2642, prose@purdue.edu

Tags: Quality Services

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